Arch.Geflügelk., 72 (1). S. 2–7, 2008, ISSN 0003-9098.
© Verlag Eugen Ulmer, Stuttgart
Poultry coccidiosis: prevention and control approaches
Geflügelkokzidiose: Prophylaxe- und Kontrollmaßnahmen
Hafez Mohamed Hafez1
Herrn Prof. Dr. Gerhard Monreal zum 80. Geburtstag gewidmet
Introduction
Coccidiosis is the major parasitic disease of poultry with
substantial economic losses due to malabsorption, bad
feed conversion rate, reduced weight gain and increased
mortality. In addition, the use of anticoccidial drugs
and/or vaccines for treatment and prevention, contributes
a major production cost.
Aetiology
Coccidia are protozoa which have the ability to multiply
rapidly inside cells lining the intestine or caeca. The spe-
cies of coccidia that are infective to poultry belong to the
Eimeria genus. Many of these species can infect poultry
and there is no cross-immunity between them. Most in-
festations under field conditions are mixed but one species
will be dominant. Eimeria have a self-limiting life cycle and
are characterized by a high tissue and host specificity.
The Eimeria cycle includes two distinct phases; (a) the
internal phase (schizogony + gamogony) in which the pa-
rasite multiplies in different parts of the intestinal tract and
the oocysts are excreted in the faeces (The part of the in-
testinal tract and the total duration of the internal phase of
the cycle is dependant on species), (b) the external phase
(sporogony) during which the oocyst must undergo a final
process called sporulation before they are again infective.
Sporulation requires warmth (25–30°C), moisture and
oxygen (LEVINE, 1982).
Seven species of Eimeria are known to infect chickens
and they show a wide variation in their pathogenicity
(Tab. 1). In addition, two further species have been descri-
bed, namely E. hagani and E. mivati, but further studies on
the importance of these species are needed (CONWAY and
MCKENZIE, 2007).
In turkeys seven species of Eimeria have been reported
(Tab. 2), however E. innocua and E subrotunda are consi-
dered non-pathogenic (TREES, 1990; MCDOUGALD, 2003).
Geese are parasitized by two species; Eimeria truncata
(unusually this is found in the kidney) and Eimeria anseris.
A large number of specific coccidia have been also reported
in ducks, but the validity of some of them is still not clear.
The most pathogenic coccidial infection of ducks is Tyzze-
ria perniciosa, which causes haemorrhagic enteritis in
1Instituteof Poultry Diseases, Faculty of Veterinary Medicine, Free University
Berlin, Germany
ducklings less than 7 weeks of age (TREES, 1990; MCDOUGALD,
2003).
Transmission
The oocysts are extraordinary resistant to environmental
stress and disinfectants, remaining viable in the litter for
many months. Temperatures above 56°C and below 0°C
are lethal but it seems to be impossible to decontaminate a
previously contaminated poultry house or environment.
Sporulated oocysts can be spread mechanically by wild
birds, insects or rodents and via contaminated boots,
clothing, equipment or dust. Direct oral transmission is the
natural route of infection (MCDOUGALD, 2003).
Clinical signs and lesions
Several Eimeria species are able to cause clinical signs in
infected and unprotected birds; however subclinical infec-
tions are frequently seen. These are often underestimated
but mostly result in impaired feed conversion and reduced
weight gain.
Coccidiosis generally occurs more frequently during the
warmer months of the year (SMITH, 1995). Young birds are
more susceptible and more readily display signs of disease,
whereas older chickens are relatively resistant as a result of
prior infection.
The severity of an infection depends on; the age of birds,
Eimeria species, number of sporulated oocysts ingested,
immune status of the flock and environmental manage-
ment.
Infected birds tend to huddle together, have ruffled
feathers and show signs of depression. The birds consume
less feed and water, and droppings are watery to whitish or
bloody. This results in dehydration and poor weight gain as
well as mortalities.
The lesions of coccidiosis depend on the degree of in-
flammation and damage to the intestinal tract. They inclu-
de thickness of the intestinal wall, mucoid to blood-tinged
exudates, petechial haemorrhages, necrosis, haemorrhagic
enteritis and mucous profuse bleeding in the caeca.
The tissue damage in the intestinal tract may allow
secondary colonization by various bacteria, such as
Clostridium perfringens (HELMBOLT and BRYANT, 1971), or
Salmonella Typhimurium (ARAKAWA et al., 1981; BABA et
al., 1982). Infestation with E. tenella also increases the
severity of Histomonas meleagridis infection in chickens
(MCDOUGALD and HU, 2001).
Diagnosis
Coccidiosis is often extremely difficult to diagnose and can
only be done in the laboratory (CONWAY and MCKENZIE,
Arch.Geflügelk. 1/2008

Tab. 1. Some characteristics of important Eimeria spp. infecting chickens
Einige Merkmale der wichtigsten Eimeria spp. bei Hühnern
Host Eimeria
Chickens E. acervulina
E. brunetti
E. maxima
E. mitis
E. necatrix
E. praecox
E. tenella
* – non-pathogenic; + low pathogenic; ++ moderately pathogenic; +++ highly pathogenic
Tab. 2. Some characteristics of important Eimeria spp. infecting turkeys
Einige Merkmale der wichtigsten Eimeria spp. bei Puten
Host Eimeria
Turkeys E. adenoeides
E. dispersa
E. gallopavonis
E. innocua
E. meleagridis
E. meleagrimitis
E. subrotunda
* – non-pathogenic; + low pathogenic; ++ moderately pathogenic; +++ highly pathogenic
2007), by counting coccidia per gram of faeces and/or
examining the intestinal tract to determine the lesion
scores, as described by JOHNSON and REID (1970). The esti-
mation of the lesion scores is difficult in turkeys (IRION,
1999). Since it is common for healthy birds to possess some
coccidia, consideration of flock history and lesion scores
must be carefully evaluated before making a diagnosis or
treatment recommendations.
Intestinal coccidiosis may be confused with necrotic
enteritis, haemorrhagic enteritis, or other enteric diseases.
Caecal coccidiosis may be confused with histomoniasis and
salmonellosis due to their similar lesions (HAFEZ, 1997).
Prevention and Control: Yesterday, Today and Tomorrow
In the past it has been realized that eradication of coccidia
is not realistic and hygienic measures alone are not able to
prevent infections. However, if an outbreak of coccidiosis
occurs, treatment via the drinking water should start as
soon as possible. The most commonly used drugs are sul-
phonamides, amprolium and toltrazuril. Today the preven-
tion and control of coccidiosis is based on chemotherapy,
using anticoccidial drugs and/or vaccines along with hygi-
enic measures and improved farm management.
Anticoccidial drugs
According to SHIRLEY and CHAPMAN (2005) the most signifi-
cant study that had the greatest impact on control of cocci-
diosis was that of DELAPLANE et al., (1947) which showed
that the administration of low concentrations of sulpha-
quinoxaline in the feed effectively controlled the disease.
Arch.Geflügelk. 1/2008
Hafez: Poultry coccidiosis prevention 3
Location Pathogenicity*
Duodenum, Jejunum ++
Ileum, Rectum +++
Duodenum, Jejunum, Ileum ++
Duodenum, Jejunum +
Jejunum, Caeca +++
Duodenum, Jejunum +
Caeca +++
Location Pathogenicity
Caecum +++
Duodenum, Jejunum +
Rectum ++
Duodenum, Jejunum –
Caecum +
Duodenum, Jejunum +++
Duodenum, Jejunum –
The rapid development of the broiler industry in the
1950 s required the urgent availability of anticoccidial
drugs. This soon led to intensive activities by several com-
panies to produce a range of chemical products that were
effective in the control coccidiosis. However, these pro-
ducts also prevented treated birds from building up any
natural immunity and they were not effective enough to
kill all exposed coccidia. The result was that the surviving
coccidia quickly became resistant to the products and
severe outbreaks of the disease occurred. According to
CHAPMAN (1994a) nicarbazin was introduced in 1955 to the
USA and was extensively used in broiler production. In the
1970 s several other highly efficacious synthetic drugs
were introduced but due to the rapid development of drug
resistance, they were withdrawn shortly afterwards. The
development of resistance was documented for these anti-
coccidial chemical drugs (JEFFERS, 1974a,b; MCDOUGALD et
al., 1986). It is likely that resistance has developed to more
recent anticoccidial drugs but this has not been investiga-
ted and may have gone unrecorded (CHAPMAN, 2005).
A major enhancement in coccidiosis control occurred in
the 1970’s with the introduction of monensin as the first
ionophore coccidiostat. Introduction of ionophores chan-
ged the ability to control coccidiosis – an impact that
remains to this day (SHIRLEY and CHAPMAN, 2005). The
effectiveness of ionophore coccidiostats lies in the fact that
whilst they kill the majority of the invading parasites, they
permit a small leakage of coccidia enabling a degree of
host immunity to develop. Resistance to ionophores deve-
lops very slowly and there is more of a tendency to increa-
sed levels of tolerance. CHAPMAN and HACKER (1994) as well
as MATHIS (1999) observed a marginal to poor effect of
different ionophores to several Eimeria sp.
4 Hafez: Poultry coccidiosis prevention
Tab. 3. Some anticoccidial drugs used for prevention in chickens and turkeys in the EU
Zusatzstoffe zur Verhütung der Kokzidiose bei Hühnern und Puten in der EU

Brand Name Category of Max. Age Conc. (ppm) Withdrawal

Generic name Min. Max.
Manufacture animals (weeks) time (Days)

Broiler – 1 1
Clinacox
Diclazuril Pullets 16 1 1 5
Janssen
Turkey 12 1 1
Deccox
Decoquinate Broiler – 30 50 3
Alpharma
Broiler – 2 3
Stenorol
Halofuginone Pullets 16 2 3 5
Huvepharma
Turkey 12 2 3
Broiler – 75 125
Avatec
Lasalocid sodium Pullets 16 75 125 5
Alpharma
Turkey 12 90 125
Maduramicin Cygro Broiler – 5 5
5
ammonium Alpharma Turkey 16 5 5
Broiler – 100 125
Elancoban
Monensin sodium Pullets 16 100 125 3
Elanco
Turkey 16 60 100
Coxidin Broiler – 100 125
Monensin sodium 3
Huvepharma Turkey 16 90 100
Monteban
Narasin Broiler – 70 70 1
Elanco
Narasin/ Maxiban
Broiler – 80 100 5
Nicarbazin Elanco
Cycostat Broiler
Robenidine HCl – 30 36 5
Alpharma Turkey
Sacox Broiler – 60 70
Salinomycin sodium 1
Huvepharma Pullets 12 50 50
Salinomax
Salinomycin sodium Broiler – 50 70 1
Alpharma
Aviax
Semduramicin Broiler – 20 25 5
Forum

Since the 1970’s, coccidiostats have been regulated un-
der the Feed Additives Directive 524/70/EEC (EEC, 1970;
2004), which has now been replaced by Regulation No
1831/2003/EC (EC, 2003; 2007). As such, they have not
been subject to veterinary prescription status, since they
are required routinely in the feed of commercial broilers
and turkeys.
Currently several types of anticcocidial drugs are avai-
lable including synthetic compounds (chemicals), quina-
lone and certain ionophore antibiotics (Tab. 3). In recent
years, however, few new drugs have been introduced. All
types of drug used for coccidiosis control are unique; in
their mode of action, the way in which parasites are killed
or arrested, and the effects of the drug on the growth and
performance of the bird. Very few drugs are equally effica-
cious against all Eimeria species (MCDOUGALD, 2003).
The efficiency of anticoccidial agents can be reduced by
drug resistance and management programmes are desig-
ned to prevent this developing, which results in better gut
health and feed utilization by birds. Using a drug rotation,
with constant monitoring of the oocysts in the faeces and
in the litter, or shuttle programme (ionophore/chemical)
seems to be of great value. Rotation involves changing the
product used every 4–6 months. The alternative to a rota-
tion programme is a continuous program where the same
products are used until a problem develops or until a new
product is introduced on the market. Rotations are only
possible if drugs with different mode of action follow each
other. On the other hand, a shuttle programme uses two or
more products during the grow-out period of a flock. The
principle is to use the drug most suited to each phase of the
grow-out, so that one drug is used for the starter period,
whilst another is used during the grower and finisher pha-
se. The drug withdrawal period is a very important consi-
deration for treatments used in finisher feeds (PAEFFGEN et
al., 1988; SMITH, 1995). A ‘switch’ system can also be used
where the anti-coccidial agent is changed at each resto-
cking within an operation.
A coccidiosis ‘break’ is often an indication of an immu-
nosuppression problem. Concurrent infection with immu-
nosuppressive diseases such as Marek’s disease may inter-
fere with development of immunity to coccidiosis (BIGGS et
al., 1969) and infectious bursal disease (IBD) may exacer-
bate coccidiosis, placing a heavier burden on anticoccidial
drugs (MCDOUGALD et al., 1979).
Vaccination
The poultry industry is facing problems of drug resistance,
a lack of new anticoccidial products, the susceptibility of
turkeys to ionophore toxicity and consumer pressure to de-
crease the use of antibiotics in animal feed. It is therefore
being forced to seek alternative strategies to control Cocci-
diosis, which has made the use of vaccines more attractive.

Arch.Geflügelk. 1/2008

Although it has been known for many years that the host
exposure to low numbers of coccidia oocysts allows the
development of a protective immunity, live coccidiosis
vaccines weren’t used in poultry until the 1960’s. There is
now a tremendous amount of knowledge about the immune
response of chickens to coccidia infections (LILLEHOJ, 2005)
and the development and use of vaccines is increasing (WIL-
LIAMS, 2002; SHIRLEY and CHAPMAN, 2005; SHIRLEY, 2000).
Several different live vaccines have been commercially
developed and they are mostly composed of either virulent
or attenuated parasitic strains. Non-attenuated vaccines
have been used for many years in the USA. Coccivac®
vaccine (Schering Plough Animal Health) was developed
in the early 1950 s. The “B” and “D” types are different mix-
tures of Eimeria species; the “T” type is for turkeys and was
introduced in 1970’s (WILLIAMS, 2002; SHIRLEY and CHAP-
MAN, 2005). In addition, Immucox® and Immuncox – T®
were developed in Canada (Vetech Laboratories) and have
also been used for many years (JULIAN et al., 1999).
Towards the end of the 1980’s new live attenuated
vaccines came onto the market including; Paracox® (Sche-
ring-Plough Veterinary Ltd, UK) and Livacox® (Biopharm,
Czech Republic). They have been characterized, for their
short life cycle, as “precocious” (JEFFERS, 1975) and with
their reduced pathogenicity were introduced commercially
in the EU (SHIRLEY, 2000).
Recently three further live non-attenuated vaccines have
developed; Nobilis® CoxATM (Intervet), ADVENT™ and
Inovocox™. Nobilis® CoxATM consists of a mixture of
wild-type Eimeria spp. that is relatively tolerant to iono-
phores (VERMEULEN et al., 2001). Advent™ (Viridus Animal
Health, USA) is marketed as having more viable oocysts
(truly sporulated oocysts that can cause immunity) than
other vaccines and Inovocox™ (Embrex) was designed for
administration in ovo. Other live vaccines have been repor-
ted to be under development and/or introduced in some
countries (WILLIAMS, 2002; CONWAY and MCKENZIE, 2007).
Recently a sub-unit vaccine CoxAbic® (Abic-Israel) has
been introduced, prepared from purified gametocyte anti-
gen, isolated from E. maxima (WALLACH et al., 1995).
Broiler breeder flocks vaccinated, twice intramuscularly,
during the rearing period are able to pass maternal antibo-
dies to their offspring and immunity to infection has been
demonstrated with E. acervulina, E. maxima, E. mitis and
E. tenella (FINGER and MICHAEL, 2005).
Commercial use of coccidia vaccines in the EU began in
1992 with the introduction of a vaccine for replacement
breeders and laying pullets, followed in 2000 by a vaccine
for commercial broilers. Now vaccines are used as the
primary method for coccidiosis prevention in breeding
flocks and to some extent in laying hens and broiler
chickens. Currently, three vaccines are available, EU-wide
(Paracox®-5 and Paracox®-8) and one other (Livacox®) is
available in a limited number of countries (Czech Repub-
lic, Italy, Latvia and Slovak Republic). Vaccines have pro-
ved to be a valid addition to coccidiosis control in commer-
cial broilers and it is estimated that approximately 12% of
the commercial broilers produced in Europe rely on vacci-
nes alone for coccidiosis control. Most of these are found in
Southern Europe where season and climate favours a
lower coccidiosis challenge (FEFAC, 2007).
The use of vaccines is able to replace drug-resistant field
strains of Eimeria with “drug-sensitive” vaccine strains.
This is observed in the restoration of sensitivity to ionopho-
res such as monensin and salinomycin as well as to the
chemical drug diclazuril (CHAPMAN, 1994b; CHAPMAN et al.,
2002; MATHIS, 2003).
Long-term sustainability of coccidiosis control in poultry
may therefore be facilitated by the adoption of rotation
Arch.Geflügelk. 1/2008
Hafez: Poultry coccidiosis prevention 5
programs, involving the alternate use of a vaccine and
drugs in successive flocks. Programs involving the rotation
of vaccines with traditional chemotherapy are currently
used by the poultry industry. The highly effective chemical
anticoccidials need only be used for specific cycles, when
conditions in the house produce a greater coccidiosis chal-
lenge. Chemical use, limited to a single cycle, will dramati-
cally reduce oocyst levels in the facility. The following
cycles can then use vaccination to repopulate the house
with anticoccidial-sensitive oocysts, which are highly
sensitive to both the chemical and ionophore programs.
The vaccination cycles should be followed by the use of an
ionophore, which should perform very efficiently in the
vaccine-repopulated house (RADU, 2004).
Currently some trails are being carried out on the effi-
cacy of alternative products such as herbal extracts under
controlled challenges and many have not shown measu-
rable coccidiosis prevention. CHRISTAKI et al. (2004) inves-
tigated the effect of dietary supplementation with Apacox
(Apa-CT, s.r.l. Italy), a commercial preparation of herbal
extracts, on the performance of broiler chickens experi-
mentally infected with Eimeria tenella. The obtained
results indicated that Apacox exerted a coccidiostatic effect
against E. tenella. This effect was, however, significantly
lower than that exhibited by lasalocid. DUFFY et al. (2005)
carried out investigations on the effects of dietary supple-
mentation of Natustat™ a plant derived product (Alltech
Inc., KY, USA) and salinomycin on performance, feed effi-
ciency and intestinal lesion scores in broiler chickens, chal-
lenged with Eimeria acervulina, Eimeria maxima and
Eimeria tenella challenge. In first trial birds were challen-
ged via contaminated litter with known amount of Eimeria
oocysts. In the 2nd trial trail the source of challenge was the
litter from the 1st trial. The performance parameters were
significantly improved by the addition of Natustat™
(1,925 Kg/tonne) and salinomycin (66 g/tonne) to the
diets of challenged birds, compared to non-supplemented
birds. They concluded that Natustat™, a propriety natural
a alternative for protozoal control, is as effective as Salino-
mycin. On the other hand CLAVÉ HUBERT and VAN DER HORST,
(2004) found no differences between groups treated with
an herbal product and an infected negative control, on
mortality, litter score, live weight gain or feed conversion
index.
Conclusion
Infections with coccidia are often associated with severe
economic losses. Currently the prevention and control of
coccidiosis is based on good hygiene, chemotherapy (Coc-
cidiostats) and immunization. Monitoring programmes
are essential for the early recognition strains developing
resistance. Generally, anticoccidial drugs or vaccination
alone is of little value, unless they are accompanied by im-
provements in all aspects of management. More attention
should be given to improved sanitation and hygiene at the
farm level. Including, all parameters which can improve
litter quality such as; appropriate installation and manage-
ment of watering systems, providing adequate feeding
space, maintaining recommended stocking density and
supplying adequate ventilation.
Summary
Coccidiosis is the major parasitic disease of poultry with
substantial economic losses. In the past it has been realized
that eradication of coccidia is not realistic and hygienic
6 Hafez: Poultry coccidiosis prevention
measures alone are not able to prevent infections. Today
the prevention and control of coccidiosis is based on chem-
otherapy, using anticoccidial drugs and/or vaccines along
with hygienic measures and improved farm management.
The efficiency of anticoccidial agents can be reduced by
drug resistance and management programmes are de-
signed to prevent this developing. Several different live
vaccines have been commercially developed. Long-term
sustainability of coccidiosis control in poultry in the future
may therefore be facilitated by the adoption of rotation
programs, involving the alternate use of a vaccine and
drugs in successive flocks. Currently some trails are being
carried out on the efficacy of alternative products such as
herbal extracts with various results. The present paper
review the prevention and control approaches of poultry
coccidiosis in past and future.
Key words
Coccidiosis, Chickens, Turkeys, Prophylaxis, Vaccination
Zusammenfassung
Geflügelkokzidiose Prophylaxe- und Kontroll-
maßnahmen
Die Infektion mit Kokzidien ist die bedeutendste parasitäre
Erkrankung beim Geflügel. Sie ist in der Regel mit wirt-
schaftlichen Verlusten verbunden. In der Vergangenheit
wurde festgestellt, dass eine Ausmerzung der Kokzidiose
nicht realistisch und die hygienischen Maßnahmen allein
nicht ausreichend sind, um dieses Ziel zu erreichen. Heute
stützt sich die Bekämpfung der Geflügelkokzidiose neben
den hygienischen Maßnahmen sowie der Verbesserung des
Managements vor allem auf Chemotherapie und/oder
Immunprophylaxe.
Die Wirksamkeit von Kokzidiostatika kann durch Resis-
tenzbildung herabgesetzt werden. Um das Aufkommen
von Resistenzproblemen zu verringern, werden unter-
schiedliche Anwendungsprogramme entwickelt und ein-
gesetzt. Darüber hinaus werden verschiedene Lebendimpf-
stoffe kommerziell hergestellt und zugelassen. In Zukunft
wird eine langfristige nachhaltige Kokzidiosekontrolle
beim Geflügel unterstützt durch Rotationsprogramme
bzw. Wechselanwendung von Kokzidiostatika und Impf-
stoffen in Sukzessivherden.
Zurzeit werden pflanzliche Produkte erprobt, diese
brachten unterschiedliche Ergebnisse. Die vorliegende
Übersicht fasst die Prophylaxe- und Kontrollmaßnahmen
der Geflügelkokzidiose in der Vergangenheit und von
heute zusammen.
Stichworte
Kokzidiose, Hühner, Puten, Prophylaxe, Impfung
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Correspondence: Prof. Dr. H.M. Hafez, Institute of Poultry Diseases, Faculty of
Veterinary Medicine, Free University Berlin, Königsweg 63, 14163 Berlin, Germa-
ny; E-mail: hafez@vetmed.fu-berlin.de